Effectiveness of the Bobath concept in the treatment of stroke: a systematic review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Physical Therapy

Background:

• Stroke significantly impacts sensorimotor function, necessitating effective rehabilitation strategies.
• The Bobath concept is a widely used neurodevelopmental approach for post-stroke recovery.

Purpose of the Study:

• To systematically review and synthesize evidence on the Bobath concept's effectiveness in sensorimotor rehabilitation following stroke.
• To compare the Bobath concept against alternative therapeutic interventions.

Main Methods:

• A systematic literature review was performed using major databases (PubMed, CENTRAL, CINAHL, PEDro) up to January 2018.
• Fifteen clinical trials were selected and assessed for methodological quality using the PEDro scale.
• A best-evidence synthesis approach was employed to determine the strength of evidence.

Main Results:

• The Bobath concept demonstrated no superior effectiveness compared to other post-stroke rehabilitation approaches.
• Moderate evidence suggests that therapies like forced use of the affected upper limb and constraint-induced movement therapy (CIMT) are more effective for upper limb motor control.
• No significant superiority of the Bobath concept was found for lower limb mobility, gait, balance, or activities of daily living.

Conclusions:

• The Bobath concept is not more effective than alternative methods for improving overall function in stroke survivors.
• Intensive upper limb therapies, particularly those involving high repetition and potentially robotic assistance, show greater efficacy for upper limb motor control and dexterity.
• Further high-quality, well-designed studies are required to definitively establish the comparative effectiveness of various stroke rehabilitation interventions.